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2795 2nd Street,Suite 300 <br /> �VK <br /> Davis,CA 95616 <br /> lab: 530.297.4800 <br /> L ccC Fax:530.297.4808 Lab No. 3 617:7-3> Page of <br /> Project Contact(Hardcopy or PDF To): California EDF Report? Yes ❑No <br /> Chain-of-Custody Record and Analysis Request <br /> Company/Address: I Racarrner bdbutnotnWKbb toop„ iobd sedtor� <br /> 1 4 v�1 j Sampling Company Log Code: F <br /> r K �I nc. GJ KR S Analysis Request <br /> Phone No.: FAX No.- Global ID: m x <br /> 9714 .3�2Is�,3 �i� ��Z 9`�bs -T o o- p -p p-2 .y ,� m <br /> o N w a <br /> Project Number. P.O. No: EDF Deliverable To(Email Address): in � m � rV <br /> & Z 8. /nm o 6 W C <br /> Project Name: UJ 6� _ N 6 ' _ N Co <br /> b 02 <br /> S .� r r Sampler Si ture: �, 00 m <br /> LU <br /> COw to 0 U m caD 4►, t <br /> Proj Address: CO5 = = v _ ` <br /> Sampling Container Preservative Matrix a ; a. ° — N oippp <br /> Q m m O m m m ..'LU <br /> N R L <br /> U. <br /> E u U Z Z ~ J M � C7 X X m n <br /> Sample D@SI flat1011 Date Time a _ _ � z '-8 m M o o oU> � IL01r- � w j N <br /> M w,3 -oZ <br /> Mw X -03 <br /> --Olt <br /> RelirtA rsh y: Date Time Received by: Remarks: <br /> 1 Z -12--a o4 I <br /> inquished by: Date Time Received by: <br /> Relinquished by: Date Time Received by Laboratory: .K Bill to: <br /> ;� .mss' <br /> Dishibution: White-Lab,Yellow-File,Pink-Originaror 12.11 6%. A',[ 4 <br /> Forms/Coe 121001.th9 <br />